The Effects of Individual Factors and Health Promotion During Pregnancy on Maternal-Infant Health

Abstract

The purpose of this study was to examine selected individual fact·ors which may influence the pregnant woman's engagement in health-promotion behaviors and maternal-infant health. The theoretical framework evolved from the Health Promotion Model (Pender, 1987) and the cognitive-transactional theory' of stress and coping (Lazarus & Folkman, 1984). A convenience sample of 63 low-risk and 53 high-risk pregnant women was selected for this study. The concept of high-risk in this study was na'rrowed to those women undergoing home uterine activity monitoring who were at risk for pr~term delivery. Individual factors included self-efficacy, degree of threat, perceived social support, and perceived health status. The construct of reported health-promoting behaviors was used to describe an active approach toward improved well-being. As outcome measures of health, three concepts were used as an overall index of maternal-infant health: subjective wellbeing (positive and negative affect), maternal weight gain, and infant birth weight. Regression analyses revealed that women who reported fewer negative health symptoms and a higher number of health behaviors reported higher positive affect. The change in positive affect over time for the high-risk group reflected an increase in positive mood and social engagement. A high-risk status, high degree of threat, high perceived conflict, and a higher number of negative health symptoms we're predictive of higher negative affect. Negative mood and anxiety for the high-risk group were reflected in their higher scores. The high-risk group felt greater threat from their pregnancy status, had a more negative outlook for their pregnancy, and felt less in control of the situation than did the low-risk group. While the two groups did not differ on overall reported health-promoting behaviors, the high-risk group scored significantly higher on health responsibility and lower on exercise than the low-risk group. Significant implications for nurses working with pregnant women and their families include: awareness of the need for prenatal assessment of anxiety and the meaning of the highris~ label, the need for ·improved risk assessment, continued education regarding expected physical and psychological changes "during pregnancy, and education regarding positive health behaviors.